test
TO THE EDITORS
We applaud the research performed by David Mosen and colleagues, which suggests improvements in identifying persistent asthmatics when reporting Health Plan Employer Data and Information Set (HEDIS) data.1 We were pleased that the Kaiser Permanente Health Care Program had solicited our input into the research design, so it would help resolve questions about the specificity of the HEDIS asthma measure. The analysis determined that extending the eligibility criteria to 2 years would strengthen the specificity of the current HEDIS measure by improving administrative case identification of true persistent asthmatics.
The authors' recommendation to increase the eligibility from 1 year of identification to 2 years has already been included in the latest measure specifications, which were published last July.2 This is a good example of accelerating the transfer of research into practice, and we encourage this sort of collaboration to ensure that HEDIS remains a robust and valid set of measures for performance measurement.
Phil Renner, AVP
Kevin Weiss, MD
Min Gayles Kim, MPH
National Committee for Quality Assurance Washington, DC
1. Mosen DM, Macy E, Schatz M, et al. How well do the HEDIS asthma inclusion criteria identify persistent asthma? Am J Manag Care. 2005;11:650-654.
2. National Committee for Quality Assurance. Technical Specifications. Washington, DC: National Committee for Quality Assurance; 2005;460. HEDIS 2006. Health Plan Employer Data & Information Set; vol. 2.
Insurance Payer Is Associated With Length of Stay After Traumatic Brain Injury
February 21st 2025Among hospitalized patients with traumatic brain injury, Medicaid fee-for-service was associated with longer hospital stays than private insurance and Medicaid managed care organizations.
Read More
Managed Care Reflections: Insights From Richard J. Gilfillan, MD; and Donald M. Berwick, MD, MPP
February 20th 2025To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes reflections from a thought leader on what has changed over the past 3 decades and what’s next for managed care. The February issue features a retrospective by Richard J. Gilfillan, MD, former director of the Center for Medicare and Medicaid Innovation; and Donald M. Berwick, MD, MPP, former administrator of CMS.
Read More
Medical Policy Determinations for Pharmacogenetic Tests Among US Health Plans
February 10th 2025This analysis demonstrated significant variability in medical policy determinations and evidence cited for clinically relevant pharmacogenetic tests among major US health insurers and laboratory benefit managers.
Read More